H.R. 7496 — Health Investment Zones Act of 2026

This section directs the Secretary of Health and Human Services, not later than 2 years after enactment, to designate contiguous geographic areas as Health Investment Zones (HIZs) based on applications, to reduce health disparities and improve health outcomes in eligible areas with documented poor health metrics (i.e., average income below 150% of the federal poverty line; higher-than-national-average participation in the Special Supplemental Nutrition Program for Women, Infants, and Children; lower life expectancy; higher low birthweight rates; or health professional shortage area status). Applications must be submitted by community-based nonprofits or local governmental agencies in coalition with health care providers and other stakeholders, within 1 year of the Secretary's solicitation of applications (not later than 1 year after enactment), and include (1) a sustainable plan to reduce disparities and health care costs, improve outcomes, and utilize specified incentives (e.g., tax credits under new IRC §§51(d)(16) and 25G or Medicare incentives under SSA §1833(ee)); and (2) targeted diseases or health indicators (e.g., cardiovascular disease, diabetes, obesity). The Secretary must consider geographic diversity (including rural areas), prioritize applications with stakeholder support, long-term sustainability, evaluation plans, and integration with state initiatives, publish HIZ details within 1 year of all designations, and maintain designations for 10 years from the first designation date.

This section (1) expands the Work Opportunity Tax Credit—available to employers for qualified first-year wages paid to workers from targeted groups (e.g., veterans, long-term unemployed)—to include such wages paid for qualified Health Investment Zone work to a qualified Health Investment Zone worker (i.e., an individual certified as having a principal place of employment in a Health Investment Zone, employed by a Health Investment Zone practitioner with primary duties promoting healthcare access in the zone, as defined in the Health Investment Zones Act of 2026), and (2) establishes a new nonrefundable tax credit equal to 30% of wages paid to a qualified Health Investment Zone worker for such work. Both changes apply after the date of enactment.

This section authorizes the Secretary to award grants to the community-based nonprofit organization or local governmental agency that applied for a Health Investment Zone designation to support the applicant and its coalition partners in reducing health disparities and improving health outcomes in such zone. Grant funds must be consistent with the grantee’s plan submitted under section 2(d)(1) and may be used for (1) subgrants to Health Investment Zone practitioners—those owning/leasing or providing health care in a zone facility—to defray up to the lesser of $5 million or 50% of costs for equipment or capital/leasehold improvements implementing innovative strategies; and (2) such strategies, including internships and volunteer opportunities for zone residents, resources to serve non-English speakers, operation of mobile medical/mental/behavioral/dental clinics, patient transportation to appointments, improved access to healthy food/recreation/housing, and facility improvements/equipment.

This section establishes a student loan repayment program under which the Secretary of Health and Human Services enters into agreements with eligible Health Investment Zone practitioners to repay up to $10,000 per year (not to exceed $100,000 total over 10 years) on the principal and interest of their eligible educational loans (i.e., federally funded or guaranteed student loans) in exchange for providing full-time health care services in a Health Investment Zone for at least one year. Such repayments count toward loan forgiveness or cancellation requirements under specified Higher Education Act of 1965 provisions, including Public Service Loan Forgiveness under section 455(m) (20 U.S.C. 1087e(m)); prohibits double payments for the same service under this program and other federal loan repayment programs; and bars repayments for loans already forgiven, cancelled, or repaid.

This section establishes incentive payments under Medicare Part B (i.e., supplementary medical insurance covering physician services and other outpatient care) for items and services furnished in areas designated as Health Investment Zones under the Health Investment Zones Act of 2026. In addition to amounts otherwise payable under Part B, it directs payment of (1) 10% of the Part B payment amount for such items and services; (2) an additional 5% of the Part B payment amount for items and services furnished at a freestanding physician office or clinic (i.e., billing under place of service codes 11 or 22 and not owned or controlled by a hospital system per PECOS) or a federally qualified health center; and (3) an additional 10% of the Part B payment amount for annual wellness visits (HCPCS codes G0438–G0439), diabetes self-management training (CPT codes 98960–98962), chronic care management (CPT codes 99487–99491), mammography, or colorectal cancer screening. These payments are made monthly or quarterly and coordinate with (i.e., are paid without regard to) certain other Part B add-on payments under subsections (m) and (z).

This section requires the Secretary to submit to Congress, not later than 10 years after the first Health Investment Zone is designated, a report on the implementation and results of this Act (and amendments made by this Act). The report must (1) specify the number and types of incentives provided in each Health Investment Zone and (2) include evidence of the extent to which those incentives succeeded in attracting health care practitioners to such zones, reducing health disparities and costs, improving health outcomes, and lowering hospital admissions and readmissions therein, as well as their impact on primary care access and emergency room utilization.

This section defines key terms for purposes of the Act: (1) Health Investment Zone as an area designated under section 2; (2) Health Investment Zone practitioner as a health care practitioner licensed or certified under state law to treat patients in such a zone, who provides primary care (including obstetrics, gynecology, pediatrics, or geriatrics), behavioral health (including mental health or substance use disorder services), or dental services, and who participates in Medicare (title XVIII of the Social Security Act) or Medicaid (title XIX); and (3) Secretary as the Secretary of Health and Human Services.

This section authorizes appropriations of such sums as may be necessary to carry out the Act from the date of enactment through the last day of the 10-year period beginning on the date the first Health Investment Zone is designated.